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Öğe Abdominal blockage of iliohypogastric and ilio-inguinal nerves for management of post-caesarean pain: A novel method(SA MEDICAL ASSOC HEALTH & MEDICAL PUBL GROUP, 2012) Boztosun, Abdullah; Duger, Cevdet; Kosar, Mehmet Ilkay; Salk, Ismail; Gursoy, Sinan; Muderris, Iptisam Ipek; Yanik, AliObjective. The aim of this study was to compare pain relief after caesarean section achieved by an intra-abdominal iliohypogastric and ilio-inguinal (IHII) nerve block with levobupivacaine with that in patients given a placebo. Study design. A total of 60 healthy women scheduled for caesarean delivery under general anaesthesia were enrolled in the study. The patients were randomised to an abdominal IHII nerve block with levobupivacaine (levobupivacaine group) or administration of saline (placebo group). Instead of the classic percutaneous method, the block was administered intra-operatively from the peritoneal aspect. Scores on a visual analogue scale (VAS) at 2, 6, 12 and 24 hours, adverse effects, morphine consumption and success of blockage by a pinprick test were recorded. Results. In the levobupivacaine group, the pinprick test showed there to be successful bilateral block in 22 patients and unilateral block in 5, while the block failed in 3. No block was recorded in the placebo group. When morphine consumption at 12 and 24 hours were compared, consumption was found to be significantly low for both time points in the levobupivacaine group. VAS scores 2, 6 and 12 hours after the operation were also significantly lower in the levobupivacaine group. Conclusion. A block of the IHII nerves from inside the abdomen just before abdominal closure appears to be an effective and safe way of relieving pain after caesarean section.Öğe The availability of vaginal hysterectomy in benign gynecologic diseases: A prospective, non-randomized trial(WILEY-BLACKWELL, 2010) Guvenal, Tevfik; Ozsoy, A. Zeki; Kilcik, M. Ali; Yanik, AliObjective: To determine whether vaginal hysterectomy can be performed in patients with benign gynecologic diseases regardless of uterine size, uterine mobility and previous pelvic surgery and to compare with abdominal hysterectomy. Study Design: Between 2003 and 2008, we compared 47 vaginal hysterectomies (VH) with 61 abdominal hysterectomies (AH). We excluded from the study the clinical conditions that mandate abdominal exploration and standard indications for VH such as uterovaginal prolapse. Large, immobile uterus and previous pelvic surgery were not accepted as a contraindication for VH. Demographic characteristics, primary diagnosis, uterine weight, operation time, intraoperative blood loss, complications, and hospital stay and cost in both groups were compared. Results: Groups were similar with respect to demographic features and primary indications. Mean uterine weight and mean operation time were similar in VH and AH groups (258.0 g vs 293.9 g and 93.7 min vs 101.4 min, respectively). Oopherectomy was performed in 44.7% of VH and in 83.6% of AH. Colporrhaphies and/or anti-incontinence surgery were performed in 15 patients in the VH group (31.9%). The intraoperative blood loss was lower in the VH group than the AH group (245.0 mL vs 408.6 mL, P < 0.001). Perioperative complications were increased with AHs. The mean hospital stay and operation cost in the VH group were significantly less than the AH group (P < 0.001). Conclusion: This study indicates that vaginal hysterectomy could be performed with less morbidity in patients with benign gynecologic diseases even in large, immobile uterus and previous pelvic surgery.Öğe Cytoreductive Surgery Followed by Hyperthermic Intraperitoneal Chemotherapy: Morbidity and Mortality Analysis of Our Patients(ORTADOGU AD PRES & PUBL CO, 2012) Karadayi, Kursat; Turan, Mustafa; Karadayi, Sule; Alagozlu, Hakan; Kilickap, Saadettin; Buyukcelik, Abdullah; Sarkis, Cihat; Yucel, Birsen; Boztosun, Abdullah; Cetin, Meral; Yilmaz, Abdulkerim; Yanik, Ali; Sen, MetinObjective: The purpose of this study was to analyze the morbidity and mortality of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) and early postoperative intraperitoneal chemotherapy (EPIC) with closed abdomen technique in the treatment of peritoneal surface malignancies. Material and Methods: Twenty-six patients (8 with ovarian cancer, 7 peritoneal mesothelioma, 6 colorectal cancer, 3 uterine sarcoma, 1 peritoneal carcinoma and 1 with gastric cancer) underwent 27 procedures. Peritonectomy was performed with complete removal of all the involved visceral and parietal peritoneum. HIPEC was performed with the closed abdominal technique using preheated (42.5 degrees C) perfusate for 60 minutes. EPIC was continued for postoperative 5 days. Results: All patients underwent resection of the lesions. Total pentonectomy was performed in 12 patients, while subtotal or partial peritonectomy was carried out in 14 according to the spread of carcinomatosis. Completeness of cytoreduction score of our patients was 0 in 18 patients, 1 in 6 patients and 2 in 2 patients. Major morbidity developed in 7 patients (27%). CRS+HIPEC+EPIC yielded acceptable morbidity and mortality rates. Of the 26 patients, 20 (77%) were alive without evidence of disease with a mean follow-up period of 13 6 months. Overall 1 year survival was 60%. Conclusion: Cytoreductive approach combined with intraperitoneal chemotherapy prolongs survival in selected patients with peritoneal carcinomatosis (PC) with acceptable morbidity and mortality.Öğe Determination of PD-1 expression in peripheral blood cells in patients with endometriosis(Taylor & Francis Ltd, 2021) Oksasoglu, Bugra; Hepokur, Ceylan; Misir, Sema; Yildiz, Caglar; Sonmez, Gamze; Yanik, AliIn patients with endometriosis, ectopic endometrial tissues can escape from immune system control and survive in other tissues. The pathophysiology of endometriosis is still not fully understood. In this study, we aimed to clarify the pathophysiology of endometriosis, which is thought to be a benign but infiltrative cancer type, which has many similarities with cancer biology by determining PD-1 expression in patients with endometriosis. In this study, n = 73 cases who underwent surgery or examination at the Obstetrics and Gynecology Clinic of Sivas Cumhuriyet University Faculty of Medicine and diagnosed as endometriosis in the biopsy material taken with the pre-diagnosis of endometriosis constituted the patient group. The control group consisted of n = 64 healthy subjects without concomitant malignancy or chronic inflammatory disease. Venous whole blood samples were obtained from the study groups. PD-1 and PD-L1 levels were determined by the ELISA method from serum and plasma samples. PD-1 gene expression level was determined by RT-PCR. The PD-1 level was found to be approximately 350 +/- 150 ng/L and 45 +/- 17 ng/L in endometriosis and control group, respectively. While the PD-L1 level was approximately 760 +/- 108 ng/L in the patients, this level was 140 +/- 14 ng/L in the controls. According to the RT-PCR results, the expression of the PD-1 gene 10 times higher compared to the controls. Conclusion: The identified increase of PD-1 levels and gene expression in endometriosis groups show that immunotherapy may be used in the treatment of endometriosis.Öğe Genetic variants in the microRNA machinery gene (Dicer) have a prognostic value in the management of endometrial cancer(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2018) Oz, Muhammed; Karakus, Savas; Yildirim, Malik; Bagci, Binnur; Sari, Ismail; Bagci, Gokhan; Yildiz, Caglar; Akkar, Ozlem; Cetin, Ali; Yanik, AliAim: Although several associations were found between Dicer rs3742330 single nucleotide polymorphism (SNP) and development and prognosis of some epithelial cancers, relationship between the SNP rs3742330 and endometrial cancer (EC) has not yet been studied. We aimed to investigate the prognostic role of rs3742330 SNP of Dicer gene in EC patients. Subjects and Methods: A total of 80 EC patients and 80 control subjects included in the study. Real-time polymerase chain reaction and the allele discrimination technique was used for genotyping of rs3742330 SNP. Results: There was no significant difference between EC patients and control subjects with regard to the genotype and allele frequencies for Dicer rs3742330 SNP (P > 0.05). Despite Dicer rs3742330 SNP had no prognostic value in terms of stage, grade, lymphovascular invasion, myometrial invasion, tumor size, and histopathology; malignant peritoneal cytology has been detected higher in the patients bearing AA genotype compare with AG genotype (P = 0.023). Higher recurrence rate and shorter time to recurrence were found in patients bearing AG and GG genotype compare with AA genotype (P = 0.009). Conclusion: Dicer rs3742330 AG and GG genotypes may have the potential to be used as a predictor of poor prognosis in the management of EC case.Öğe LIVER DISEASES IN PREGNANCY(Galenos Yayincilik, 2008) Sarkis, Cihat; Imir, Gonca; Ugurlu, Serdal; Caglar, Erkan; Yanik, AliLiver disease in pregnancy is rare and it is associated with the high maternal and neonatal mortality rate. Some of the liver diseases are specific for pregnancy. The most common liver diseases in pregnancy are Acute fatty liver of pregnancy, Intrahepatic cholestasis of pregnancy, HELLP syndrome, liver dysfunction due to preeclampsia, hyperemesis gravidarum, Hepatitis E of pregnancy, and other Hepatitis infections, and Budd-Chiari syndrome. In this review, incidence, risk factors, pathogenesis, clinical presentation, diagnosis, treatment and outcome of those liver diseases unique to pregnancy are discussed through the literature.Öğe Multicenter Analysis of Gestational Trophoblastic Neoplasia in Turkey(ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2014) Ozalp, Sabit Sinan; Telli, Elcin; Oge, Tufan; Tulunay, Gokhan; Boran, Nurettin; Turan, Taner; Yenen, Mufit; Kurdoglu, Zehra; Ozler, Ali; Yuce, Kunter; Ulker, Volkan; Arvas, Macit; Demirkiran, Fuat; Bese, Tugan; Tokgozoglu, Nedim; Onan, Anil; Sanci, Muzaffer; Gokcu, Mehmet; Tosun, Gokhan; Dikmen, Yilmaz; Ozsaran, Aydin; Terek, Mustafa Cosan; Akman, Levent; Yetimalar, Hakan; Kilic, Derya Sakarya; Gungor, Tayfun; Ozgu, Emre; Yildiz, Yunus; Kokcu, Arif; Kefeli, Mehmet; Kuruoglu, Serkan; Yuksel, Hasan; Guvenal, Tevfik; Hasdemir, Pinar Solmaz; Ozcelik, Bulent; Serin, Serdar; Dolanbay, Mehmet; Arioz, Dagistan Tolga; Tuncer, Nadire; Bozkaya, Hasan; Guven, Suleyman; Kulaksiz, Deniz; Varol, Fusun; Yanik, Ali; Ogurlu, Gonca; Simsek, Tayyup; Toptas, Tayfun; Dogan, Selen; Camuzoglu, Hakan; Api, Murat; Guzin, Kadir; Caliskan, Eray; Doger, Emek; Cakmak, Bulent; Ilhan, Tolgay TuyanBackground: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.Öğe Prevalence of cervical cytological abnormalities in Turkey(WILEY, 2009) Kara, Fadil; Kiran, Guerkan; Metindir, Jale; Ozan, Hakan; Ozalp, Sinan; Vardar, M. Ali; Zeren, Handan; Dilek, Saffet; Bozkaya, Hasan; Guven, Sueleyman; Ersoz, Safak; Acikalm, Arbil; Meydanli, Mutlu; Cetinarslan, Ilknur; Gokaslan, Huesnu; Eren, Funda; Celik, Cetin; Yilmaz, Osman; Celik, Huesnue; Aksaz, Zeliha; Kocak, Cengiz; Bagci, Hafize; Davutoglu, Bilge Sel; Hakverdi, Ali Ulvi; Soysal, Mehmet Emin; Kaya, Guelcan; Yanik, Ali; Arici, Sema; Cetin, Halit; Mutlu, Ahmet Emin; Kolusari, Ali; Kosem, Mustafa; Sahin, Guler; Demirturk, Fazli; Gultekin, Murat; Karaca, Mehmet; Harma, Mehmet; Harma, Muege; Batur, Sebnem; Demirbag, Nilgun; Baykal, Cem; Dogan, Isin; Sam, Asli DemirObjective: To evaluate retrospectively the prevalence of cervical cytological abnormalities in patient records obtained from healthcare centers in Turkey. Method: Demographic characteristics and data on cervical cytological abnormalities were evaluated from patients who underwent flap tests in healthcare centers in 2007. Results: Data were collected from 33 healthcare centers totaling 140 334 patients. Overall, the prevalence of cervical cytological abnormalities was 1.8%; the prevalence of ASCUS, ASC-H, LSIL, HSIL, and AGC was 1.07%, 0.07%, 0.3%, 0.17%, and 0.08%, respectively. The prevalence of preinvasive cervical neoplasia was 1.7% and the prevalence of cytologically diagnosed invasive neoplasia was 0.06%. Conclusion: The abnormal cervical cytological prevalence rate in Turkey is lower than in Europe and North America. This might be due to sociocultural differences, lack of population-based screening programs, or a lower HPV prevalence rate in Turkey. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.Öğe Primary Sjogren's Syndrome Adversely Affects the Female Sexual Function Assessed by the Female Sexual Function Index: A Case-Control Study(TURKISH LEAGUE AGAINST RHEUMATISM, 2017) Yildiz, Caglar; Karakus, Savas; Bozoklu Akkar, Ozlem; Sahin, Ali; Bozkurt, Birkan; Yanik, AliObjectives: This study aims to evaluate the sexual function of females with primary Sjgren's syndrome (pSS) in comparison to healthy females by using the Female Sexual Function Index (FSFI). Patients and methods: This case-control study included 31 female patients (mean age 46.0 +/- 10.2 years; range 30 to 68 years) with pSS and 27 healthy females (mean age 44.2 +/- 8.5 years; range 30 to 55 years) as control group. The sexual function of the participants was assessed by 19-item FSFI. Results: Mean duration of pSS in the patient group was 35.9 months (range 3 to 264 months). Significantly higher number of pSS patients reported positive history for vaginal infection compared to controls (n= 26, 83.9% vs n= 7, 25.9%, respectively; p< 0.001) without any difference in endocervical culture result. Cervical smear assessment revealed more inflammation and atrophy in patient group compared to control group (p= 0.001). Mean FSFI total score was significantly lower in patient group than control group (18.9 +/- 9.9 vs 25.1 +/- 5.1, respectively; p=0.004). Similarly, five out of six domains of FSFI-arousal, lubrication, orgasm, satisfaction, and pain-were significantly lower in patient group. FSFI total and subscale scores, except for pain, were found to be negatively correlated with duration of pSS. Conclusion: The pSS causes sexual dysfunction in female patients. Furthermore, as disease duration increases, female sexual function decreases. Clinical management of female patients with pSS should cover the assessment of their sexual functionality and taking the necessary precautions to maintain satisfactory quality of life and treatment outcome.Öğe Servi?kovaji?nal smearde epi?telyal hücre anomali?si? saptanan hastalarin, kolposkopi?k bi?yopsi? sonuçlarinin de?erlendi?ri?lmesi?(2012) Boztosun, Abdullah; Mutlu, Ahmet Emin; Özer, Hatice; Aker, Handan; Yanik, AliObjective: The aim of this study was evaluate a colposcopy and cervical biopsy results of patients who had diagnosed epithelial cell abnormalities. Material and Method: Between January 2007 - May 2011, outpatient clinic records of 303 patients that obtained from Department of Gynecology and Pathology of Cumhuriyet University School of Medicine were evaluated. Results: Total examined in 11,681 cervicovaginal smear of 303 (%2,6) is "epithelial cell abnormalities" were found. Epithelial cell abnormalities cases with in 194 (%64) patient is Atypical Squamous Cells of Undetermined Significance (ASC-US); 35 (%11,5) patient is Atypical Squamous Cells, Suggestive of High Grade (ASC-H); 36 (%11,9) patient is Low Grade Squamous Intraepithelial Lesion (LSIL); 9 (%3) patient is High Grade Squamous Intraepithelial Lesion (HSIL); 9 (%3) patient is Squamous Cell Carcinoma (SCC); 2 (%0,6) patient is Adenocarcinoma as defined. İn 18 patient (%6) had Atypical Glandular Cells (AGC). In premalignant lesions, cervical intraepithelial neoplasia (CIN), carcinoma in situ and invasive carcinoma that were diagnosed by cervical biopsy were considered positive results. Patients in 10 cases ASC-US (%3,3), 6 cases ASC-H (%2), 6 cases LSIL (%2), 6 cases HSIL (%2), 1 case AGC (%0,3), 6 cases SCC (%2) and 2 cases Adenocarcinoma (%0,6) were detected positive results. In total, 81 (26.7%) patients of cervical biopsy taken and 37 (12.2%) patients, positive results were obtained. Conclusion: Follow-up of patients with glandular or epithelial cell abnormalities in smear is important to both early detection and reduction of incidance of invasive cervical cancer in smear is important to both early detection and reduction of incidance of invasive cervical cancer.Öğe STOX1 gene Y153H polymorphism is associated with early-onset preeclampsia in Turkish population(Elsevier, 2020) Pinarbasi, Ergun; Cekin, Nilgun; Bildirici, Aslihan Esra; Akin, Seyda; Yanik, AliPreeclampsia (PE) is a disease of pregnancy that causes of maternal and prenatal morbidity worldwide. Studies indicate that variations in STOX1 gene may be a direct risk factor to PE but controversial results regarding the relationship of Y153H variation in the second exon of STOX1 gene with PE have been ongoing since 2005. The aim of this study was to identify if there is any correlation between Y153H polymorphisms and PE in Turkish preeclampsia patients. We performed polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) analysis in 500 pregnant women, of whom 373 pregnant women with early onset PE (EOPE) and 500 normal pregnant women. The relationship between STOX1 Y153H polymorphism and EOPE/LOPE was evaluated by statistical analysis. We found that STOX1 Y153H polymorphism is a risk factor for EOPE (p = 0.03). The odds ratio was 1,45 (CI 95% = 1,03-2,05). No relationship between STOX1 Y153H polymorphisms and LOPE (p = 0.13) was found. STOX1 gene Y153H polymorphism is associated with the risk of early onset of pre-eclampsia in a Turkish population. The results provide further evidence of the role of STOX1 in the pathophysiology of this disease.Öğe The Effect of Estrogen and Progesterone Receptor Status on the Prognosis of Endometrioid Type Endometrial Cancer: Retrospective Study(Turkiye Klinikleri, 2021) Alyazici Kucukyildiz, Irem; Yanik, AliObjective: Endometrioid-type endometrial cancer (EC) is the most common histological type of EC, and generally has good survival if diagnosed during the early stages. While tumour grade, stage and lymph node invasion are known to affect survival in these patients, the prognostic significance of steroid receptor status remains unclear. The present study aimed to determine the effect of estrogen and progesterone receptor (ER and PR, respectively) status and its relationship with other prognostic factors in endometrioid-type EC. Material and Methods: Data from 152 patients who underwent surgery at the same centre between 2009 and 2019 were retrospectively evaluated. Histological characteristics of tumours were determined using the original pathology reports, and stage, grade and lymph node involvement of tumours were compared with ER and PR status. The relationship between ER and PR status and preoperative serum cancer antigen 125 and albumin levels were also investigated. Results: When the results of our study were examined, it was revealed that 114 patients had Grade I tumor and 118 had International Federation of Gynecology and Obstetrics Stage I tumor and 34 patients had ER and PR negativity. In our study, a dependence was found between both ER and PR status and pelvic lymph node involvement. It was found that the possibility of pelvic lymph node involvement increases in both hormone receptor negativity. Conclusion: This study reports that the patients with pelvic lymph node involvement, which is a prognostic factor in EC, may experience more frequent ER and PR negativity. However, its effects on survival remain unclear.Öğe The role of two common FOXP3 gene promoter polymorphisms in preeclampsia in a Turkish population: a case-control study(Taylor & Francis Inc, 2020) Cekin, Nilgun; Pinarbasi, Ergun; Bildirici, Aslihan Esra; Hatice; Yanik, Ali; Sonmez, GamzePreeclampsia (PE), which occurs in approximately 5% of pregnancies worldwide and constitutes clinically serious complications in 2-3%, is one of the leading causes of maternal and prenatal morbidity and mortality. Recent studies report that regulatory T (Treg) cells, which act as immunosuppressant, are associated with PE. It is clearly defined that FOXP3/Scurfin (Forkhead Box P3) is involved in the development and function of Tregs. However, there are different conclusions regarding the relationship between PE and FOXP3 gene polymorphisms for different populations. For this reason, in this study we investigate the association between FOXP3 gene promoter region polymorphisms and PE in a Turkish population 500 PE patients and 500 healthy pregnant women. Blood samples taken from pregnant women were studied by PCR-RFLP method. As a result, rs2232365 polymorphism was significantly associated with disease (p < .0001) while no significant association was found between rs3761548 polymorphism and the disease (p = .17). Based on these results, it is though that FOXP3 rs2232365 polymorphism may be predisposed to PE development in terms of Turkish population. However, further and functional studies are needed in terms of other polymorphisms and mutations.IMPACT STATEMENT What is already known on this subject? A number of recent publications suggest that Tregs may play a role in the pathogenesis of PE. It is known that a stable and high FOXP3 expression is required to maintain the suppressive T cell function of Tregs. Down regulation of FOXP3 in PE has been reported in many previous studies, but the mechanism is still uncertain. What do the results of this study add? Our study has examined two FOXP3 promoter region polymorphisms in terms of Turkish population for the first time. Rs2232365 polymorphism associated with the disease in heterozygous genotype.Öğe Ultrasonographic measurement of cervical length in predicting mode of delivery after oxytocin induction(SPRINGER, 2007) Yanik, Ali; Gueluemser, Cagri; Tosun, MiracThis study was conducted to explore the value of transvaginal ultrasonographic cervical length measurement, in addition to gestational age, maternal age, parity, Bishop score, and weight of the newborn, in predicting the mode of delivery in pregnancies in which labor is induced with oxytocin at or beyond the 40th gestational week. A total of 73 pregnancies at 40 to 42 weeks of gestation were included. After labor was induced, 29 women delivered vaginally and 44 underwent cesarean section. These groups were compared with respect to possible predictive parameters of delivery outcomes. Student t test, Pearson's correlation analysis, and logistic regression analysis were used for statistical evaluation. Mean preinduction cervical length was 26.8 +/- 9.9 mm in the vaginal delivery group and 34.2 +/- 8.1 mm in the cesarean section group (P <.05). Mean maternal age, parity, and Bishop score were significantly higher and mean weight of the newborn was significantly lower in the vaginal delivery group. Cervical length measurements showed a significant negative correlation with Bishop scores (r=-.584; P <.05). Logistic regression analysis revealed that Bishop score (likelihood ratio=.472; 95% confidence interval=.338-.658; P <.05) and weight of the new born (likelihood ratio=1.002; 95% confidence interval=1.00007-1.003; P <.05) were significant independent predictors of the route of delivery. According to the results of this study, maternal age, parity, Bishop score, cervical length, and weight of the newborn all might affect the mode of delivery after labor induction. Bishop score, although a subjective measure, must be considered an important component of preinduction evaluation.
